Laserfiche WebLink
MARION COUNTY PERMIT NO: 7~ 3'7 <br />IFOR CITY VALIDATION BUILDING INSPECTION DIVISION <br /> 3150 Lancaster Dr. NE - Suite C <br /> Salem, Oregon 9730 -1398 <br /> Received By: ,0I- Date: <br /> <br />lDate: 24 HR lns_pl~'l/~l~ 73-4427 <br /> Office: p~,~ earn - 4:30pm Issued by: <br /> <br /> ELECTRICAL PERMIT APPLICATION / .~ , <br /> Please complete all Sections, I through 5 [1~jU ~; ~'q ~' FEE SCHEDULE (Complete and enter total in Al below) <br /> Number of inspections per permit allowed ~ <br /> ~aA~I~ C0U l'~ Residential Per Una <br /> 5ce Included: Items Cost (each) Sum I <br /> ~I'~ ti or less S85.00 __ 4 <br /> <br />1. LOCATION OF INSTALLATION BUILIIlNG IHSPI <br /> <br /> CITY ~] ~_0 ~2~ <br /> PROPERTY OWNER <br /> <br /> CROSS S~EET/ <br /> DI~CTIONS <br /> <br />PROJECT DESCRIPTION <br /> <br />pERMITS ARE NON-TRANSFERABLE AND EXPIRE 1F WORK IS NOT I <br /> STARTED WITH1N 180 DAYS OF ISSUANCE OR IF <br /> WORK IS SUSPENDED FOR 180 DAYS. <br /> <br />2A. CONTRACTOR INSTALLATION ONLY <br /> <br />Electrical Contractor <br />Mailing Address ~O <br />Contractors License No. <br />Contr ¢,o No. <br />Signature °f Supv' Electrician <br /> <br />Property Owner (please print) <br />Mailing Address <br /> <br />City, State, Zip <br /> <br />Each additional 500 sq B, <br /> or portion thereof $15.00 <br />Limited Energy $20,00 1 <br />Each Manufactured Home or <br />Modular Dwelling Service or Feeder $40.00 2 <br /> <br />B. Services or Feeders (Does nol include braneh cireults, see section D) <br /> <br />Installation, Alteration or Relocation <br />200 amps or less $50.00 2 <br />201 amps to 400 amps $60.00 __ 2 <br />401 amps to 600 amps $100.00 __ 2 <br />601 amps to 1000 amps $130.00 __ 2 <br />Over 1000 amps or votis $300.00 __ 2 <br />Reconnect only $40.00 __ 2 <br />C. Temporary Services/Feeders <br />hxqtallation, Altaratlans~ or Relocation <br />200 amps or less $35.00 __ 2 <br />201 amps to 400 amps $40.00 2 <br />401 amps to 600 amps $80.00 2 <br />Over 600 amps or 1000 volts see "B" above <br />D. Branch Circuits <br />New, Alteration, or Extension Per Panel <br />a) The fee h)r branch circuits ~ <br />nurchase of service or feeder fee <br />Each branch circuit $2.00 <br /> b) The fee for branch cacuds wilbO¢l <br /> vurchase of service or feeder feeNot in~cl de <br /> First branch circuit $35.00 <br /> Each additional branch circuit $2.00 <br /> E. Miscellaneous (Service or Feeder ) <br /> Each pump or irrigation circle $40.00 2 <br /> Each sign or outline ligjating $40.00 __ 2 <br /> Signal circuit(s) or a limited energy <br /> panel, alteration or extension $40.00 2 <br /> <br />}5 Each additioanl Inspection <br /> Over the allowable in any of the <br /> above, per Inspection $35.00 <br /> <br /> G. Minor Installation Labels <br /> Pack of 10 labels (o)$5.00 each $50.00 <br /> (sold only to electrical contractors) <br /> H. Other <br /> (As required by Building Officials) <br /> Aurora Dwelling Electrical Fee sq. fl. x $.068 =__ <br /> Dwelling Permit Label g of Labels <br /> <br /> Owner's Signature <br /> <br /> L PLAN REVIEW SECTION <br /> <br /> Marion County does not require a plan review. <br /> We will provide plan review service if you complete <br /> Section 5B and submit two (2) sets of plans and <br /> specifications with this application. <br /> <br />MC 15-34 7/97 <br /> <br />5. FEES <br /> AL. Enter total of fees from Sec. #4 <br /> A2 Add 5% surcharge (.05 x Al) <br /> Subtotal <br /> <br />B. Enter 25% of line Al for Plan Review <br /> (Sec. 3), if required <br />C. Investigation Fee (if required) <br />D. Reinspec0on Fee ($25.00) <br /> <br />Receipt No. <br /> <br />TOTAL AMOUNT DUE <br /> <br /> <br />